HIV-1 seroprevalence rates in women and relinquishment of infants to the state in St Petersburg, Russia, 2002

Khaldeeva, N A; Sd, Hillis; Vinogradova, Elena; Voronin, Evgeny; Rakhmanova, Aza; Yakovlev, A. A.; Jamieson, Denise J.; Ryder, R.W.

doi:10.1016/s0140-6736(03)15019-2

Cited by 19 publications

(15 citation statements)

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“…Smoking among IDUs was nearly universal (94%), and is associated with more intense NAS [48]. Maternal drug use is associated with infant abandonment in eastern Europe [49–51], and we reported recently that infants with NAS in our cohort were 10 times more likely to be abandoned than other infants [52]. …”

Section: Discussionmentioning

confidence: 84%

Prevention of mother‐to‐child transmission of human immunodeficiency virus among pregnant women using injecting drugs in Ukraine, 2000–10

Thorne

Semenenko²,

Malyuta³

2011

Addiction

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AimsTo compare clinical status, mother-to-child transmission (MTCT) rates, use of prevention of (PMTCT) interventions and pregnancy outcomes between HIV-infected injecting drug users (IDUs) and non-IDUs.Design and settingProspective cohort study conducted in seven human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) Centres in Ukraine, 2000–10.ParticipantsPregnant HIV-infected women, identified before/during pregnancy or intrapartum, and their live-born infants (n = 6200); 1028 women followed post-partum.MeasurementsMaternal and delivery characteristics, PMTCT prophylaxis, MTCT rates, preterm delivery (PTD) and low birth weight (LBW).FindingsOf 6200 women, 1111 (18%) reported current/previous IDU. The proportion of IDUs diagnosed with HIV before conception increased from 31% in 2000/01 to 60% in 2008/09 (P < 0.01). Among women with undiagnosed HIV at conception, 20% of IDUs were diagnosed intrapartum versus 4% of non-IDUs (P < 0.01). At enrolment, 14% of IDUs had severe/advanced HIV symptoms versus 6% of non-IDUs (P < 0.001). IDUs had higher rates of PTD and LBW infants than non-IDUs, respectively, 16% versus 7% and 22% versus 10% (P < 0.001). IDUs were more likely to receive no neonatal or intrapartum PMTCT prophylaxis compared with non-IDUs (OR 2.81, p < 0.001). MTCT rates were 10.8% in IDUs versus 5.9% in non-IDUs; IDUs had increased MTCT risk (adjusted odds ratio 1.32, P = 0.049). Fewer IDUs with treatment indications received HAART compared with non-IDUs (58% versus 68%, P = 0.03).ConclusionsPregnant human immunodeficiency virus-infected injecting drug users in Ukraine have worse clinical status, poorer access to prevention of mother-to-child transmission prophylaxis and highly active antiretroviral therapy, more adverse pregnancy outcomes and higher risk of mother-to-child transmission than non-injecting drug user women.

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Section: Discussionmentioning

confidence: 84%

Prevention of mother‐to‐child transmission of human immunodeficiency virus among pregnant women using injecting drugs in Ukraine, 2000–10

Thorne

Semenenko²,

Malyuta³

2011

Addiction

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“…However, the trend is also visible in areas with younger epidemics (including the cities of Moscow and St Petersburg, Novgorod, Orenburg, Rostov and Volgograd). Among pregnant women in St Petersburg, for example, HIV prevalence increased from 0.02% in 1999 to 1.25% in 2002 (Khaldeeva et al, 2002). Unless effective prevention efforts are expanded-especially among injecting drug users and their sexual partners, as well as among sex workers and their clientsthe Russian Federation's AIDS epidemic will continue to grow.…”

Section: In Neighbouringmentioning

confidence: 99%

Grand challenges in chronic non-communicable diseases

Daar

Сингер

Persad

et al. 2007

Nature

557

379

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“…It is well recognised that this marginalised group of women frequently experience problems accessing health and social services [22,23]. In a study in St Petersburg, Russian Federation among women presenting in labour with unknown HIV status, largely without antenatal care, two-thirds were IDUs [24]; HIV seroprevalence was 6.5% among women without antenatal testing, substantially higher than the 1–2% among women accessing antenatal care [25,26]. …”

Section: Discussionmentioning

confidence: 99%

Progress in prevention of mother-to-child transmission of HIV infection in Ukraine: results from a birth cohort study

Thorne

Semenenko²,

Pilipenko³

et al. 2009

BMC Infect Dis

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BackgroundUkraine was the epicentre of the HIV epidemic in Eastern Europe, which has the most rapidly accelerating HIV epidemic world-wide today; national HIV prevalence is currently estimated at 1.6%. Our objective was to evaluate the uptake and effectiveness of interventions for prevention of mother-to-child transmission (PMTCT) over an eight year period within operational settings in Ukraine, within the context of an ongoing birth cohort study.MethodsThe European Collaborative Study (ECS) is an ongoing birth cohort study in which HIV-infected pregnant women identified before or during pregnancy or at delivery were enrolled and their infants prospectively followed. Three centres in Ukraine started enrolling in 2000, with a further three joining in September 2006.ResultsOf the 3356 women enrolled, 21% (689) reported current or past injecting drug use (IDU). Most women were diagnosed antenatally and of those, the proportion diagnosed in the first/second trimester increased from 47% in 2000/01 (83/178) to 73% (776/1060) in 2006/07 (p < 0.001); intrapartum diagnosis was associated with IDU (Adjusted odds ratio 4.38; 95%CI 3.19–6.02). The percentage of women not receiving any antiretroviral prophylaxis declined from 18% (36/205) in 2001 to 7% in 2007 (61/843) (p < 0.001). Use of sdNVP alone substantially declined after 2003, with a concomitant increase in zidovudine prophylaxis. Median antenatal zidovudine prophylaxis duration increased from 24 to 72 days between 2000 and 2007. Elective caesarean section (CS) rates were relatively stable over time and 34% overall. Mother-to-child transmission (MTCT) rates decreased from 15.2% in 2001 (95%CI 10.2–21.4) to 7.0% in 2006 (95%CI 2.6–14.6). In adjusted analysis, MTCT risk was reduced by 43% with elective CS versus vaginal delivery and by 75% with zidovudine versus no prophylaxis.ConclusionThere have been substantial improvements in use of PMTCT interventions in Ukraine, including earlier diagnosis of HIV-infected pregnant women and increasing coverage with antiretroviral prophylaxis and the initial MTCT rate has more than halved. Future research should focus on hard-to-reach populations such as IDU and on missed opportunities for further reducing the MTCT rate.

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HIV-1 seroprevalence rates in women and relinquishment of infants to the state in St Petersburg, Russia, 2002

Cited by 19 publications

References 1 publication

Prevention of mother‐to‐child transmission of human immunodeficiency virus among pregnant women using injecting drugs in Ukraine, 2000–10

Prevention of mother‐to‐child transmission of human immunodeficiency virus among pregnant women using injecting drugs in Ukraine, 2000–10

Grand challenges in chronic non-communicable diseases

Progress in prevention of mother-to-child transmission of HIV infection in Ukraine: results from a birth cohort study

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